What We Can Learn from the Oldest-Old
Incredibly, half of all children born today in the developed world will live to 100 or beyond. Unfortunately, this comes at the price of extending physically and cognitively disabled life more than able life. But is it unavoidable?
A new study of 100 people with an average age of 92 tried to identify the factors that predict successful cognitive aging.
1. “Resistance” to the accumulation of amyloid and tau (plaques and tangles) is genetically determined, specifically having the APOE-2 and not the APOE-4 genotype.
2. “Resilience,” meaning maintaining cognitive function in the face of amyloid and tau pathology, is modifiable, not genetic.
Many modifiable factors have been identified (see my recent blog about the Lancet Commission). This recent study, however, concluded otherwise. Resistance depended upon genotype, as expected and non- modifiable, but also on pulse pressure, modifiable. Treat hypertension! Resilience required better baseline cognitive scores, never smoking, staying employed (not retiring), and life satisfaction.
The take-home messages: choose your parents, never smoke, treat hypertension, never retire, and figure out how to be happy.
Adapted from Snitz et al and the editorial by Kawas and Corrada, both in Neurology August 25, 2020.
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